RUNDELL, K. W., J. IM, L. B. MAYERS, R. L. WILBER, L. SZMEDRA, and H. R. SCHMITZ. Self-reported symptoms and exercise-induced asthma in the elite athlete. Med. Sci. Sports Exerc., Vol. 33, No. 2, 2001, pp. 208–213.
Purpose: The purpose of this study was to compare self-reported symptoms for exercise-induced asthma (EIA) to postexercise challenge pulmonary function test results in elite athletes.
Methods: Elite athletes (N = 158; 83 men and 75 women; age: 22 ± 4.4 yr) performed pre- and post-exercise spirometry and were grouped according to postexercise pulmonary function decrements (PFT-positive, PFT-borderline, and PFT-normal for EIA). Before the sport/environment specific exercise challenge, subjects completed an EIA symptoms-specific questionnaire.
Results: Resting FEV1 values were above predicted values (114–121%) and not different between groups. Twenty-six percent of the study population demonstrated >10% postexercise drop in FEV1 and 29% reported two or more symptoms. However, the proportion of PFT-positive and PFT-normal athletes reporting two or more symptoms was not different (39% vs. 41%). Postrace cough was the most reported symptom, reported significantly more frequently for PFT-positive athletes (P < 0.05). Sensitivity/specificity analysis demonstrated a lack of effectiveness of self-reported symptoms to identify PFT-positive or exclude PFT-normal athletes. Postexercise lower limit reference ranges (MN-2SDs) were determined from normal athletes for FEV1, FEF25–75% and PEF to be −7%, −12.5%, and −18%, respectively.
Conclusion: Although questionnaires provide reasonable estimates of EIA prevalence among elite cold-weather athletes, the use of self-reported symptoms for EIA diagnosis in this population will likely yield high frequencies of both false positive and false negative results. Diagnosis should include spirometry using an exercise/environment specific challenge in combination with the athlete’s history of asthma symptoms.